Last December, a 37-year-old patient with dissociative disorder died after hanging herself with a bedsheet and closet doorknob, a suicide that could have been prevented if Timberlawn used best practices.
The Timberlawn Mental Health System, for-profit psychiatric hospital in Dallas, is on the brink of closing, over the federal government's plan to cut funding over safety concerns.
The a 144-bed hospital with another 72-bed unit at a nearby campus could shut down on Friday unless a last-minute lawsuit convinces a judge to delay the Centers for Medicare and Medicaid Services' from pulling the plug on reimbursements.
CMS decided earlier this summer that it would end its contract with Timberlawn, a part of the Universal Health Services chain, due to a host of safety issues discovered during inspections. Medicare and Medicaid account for almost a third of Timberlawn's revenue, as the Dallas Morning News reported.
Last December, a 37-year-old patient with dissociative disorder died after hanging herself with a bedsheet and closet doorknob, a suicide that could have been prevented if Timberlawn used best practices in removing "ligature risks," as a previous internal audit suggested.
It wasn't until February that the doorknobs were replaced, but by then CMS had already found other problems, as a Dallas Morning News investigation found.
CMS inspectors found serious deficiencies, it said. Among these were "continued presence of unsafe items accessible to psychiatric patients for potential harm which included plastic liners in trash cans, electrical cords and phone cords."
Patients like the 37-year-old who hanged herself should been visited more frequently by staff based on their risks, which for her included previous suicide attempts.
CMS gave Timberlawn until June 8 to submit a corrective action plan and a final inspection was set for early July -- but the hospital apparently flunked. On July 23, CMS notified Timberlawn that it was taking the rare step of shutting off funding, after finding that the hospital was still out of compliance with proper staffing and monitoring of patients.
Nurses left key patients in detox or with a suicide risk unattended, and the "medical director failed to adequately monitor and evaluate the care provided to patients at the facility," CMS wrote in a report accessed by the Dallas Morning News.
The final survey also discovered that staff at Timberlawn falsified records at least once. As the Dallas Morning News reported, a patient swallowed a metal object and a supervisor asked a nurse to change medical notes to conceal certain details.
Founded in 1999, Timberlawn is the oldest psychiatric hospital west of the Mississippi River and one of the largest in North Texas. King of Prussia, Pennsylvania-based Universal Health Services acquired Timberlawn in 1996, but it didn't really start facing scrutiny for safety problems until 2009, according to the Dallas Morning News.
CMS told the newspaper that other psychiatric hospitals in greater Dallas will be able to handle patients from Timberlawn.
Last week, the Cochise Regional Hospital in Arizona also announced plans to close after CMS cut off Medicare funding over safety issues.